vitamin b12 deficiency in diabetic patients

The collected data was entered and analyzed by using Statistical Package for Social Sciences (SPSS) version 23.0 (SPSS Inc., IBM, Armonk, New York, USA). Mellitus Diabetic patients can easily develop a B12 deficiency as they are at a higher risk. Filioussi K, Bonovas S, Katsaros T. Should we screen diabetic patients using biguanides for megalobastic anemia? Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12deficiency: randomised placebo controlled trial. It is because diabetics mostly take metformin, which is a well-known treatment of Type-2 diabetes. There are a few different options as far as how you can treat your vitamin b12 deficiency if you are diabetic. -. Diabetes mellitus (DM) is a chronic metabolic disease with increasing prevalence worldwide. An official website of the United States government. The high consumption of meat among the Botswana population may explain the lower prevalence of vitamin B12 in our population than in other African settings. According to a study, almost 22% of people with diabetes were low in B-12, suggesting that metformin is the reason. [2] The prevalence of diabetes in Saudi Arabia alone has increased to reach 7 million cases. In this study, we found that only 4.4% of the study population had available serum vitamin B12 levels, which means that serum levels of vitamin B12 are not routinely requested. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). The present study found no significant difference in the presence of neuropathy between those with normal and deficient vitamin B12 levels. In a case-control study among Medicaid patients in the USA, vitamin B12 deficiency was found in 18% of patients using acid blockers compared with 11% in the control group.Citation32 Other previous studies have, however, found no significant association between long-term proton pump inhibitor use and vitamin B12 status.Citation8,Citation33 The connection between vitamin B12 deficiency and proton pump inhibitors or H2 blockers (acid blockers) is primarily due to decreased gastric acidity, contributing to vitamin B12 malabsorption.Citation34 Both the acid blockers and proton pump inhibitors cause a reduction in secretion and discharge of acid discharges by the parietal cells, which are essential for the breakdown of vitamin B12 from nutritional sources.Citation10,Citation34,Citation35 In the absence of gastric acid, vitamin B12 would not be cleaved from dietary protein and would not bind to R-proteins. 2016 Oct 7;17(1):44. doi: 10.1186/s40360-016-0088-3. Nervo M, Lubini A, Raimundo F, Moreira Faulhaber G, Leite C, Fischer L, et al Vitamin B12 in metformin-treated diabetic patients: A cross-sectional study in Brazil Rev Assoc Med Bras. 4 How long do vitamin B12 supplements take to work for diabetes treatment? The tool is prone to subjectivity as it is symptom dependent, and there is a possibility of misclassification of participants. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? A single copy of these materials may be reprinted for noncommercial personal use only. Viollet B, Guigas B, Garcia N, Leclerc J, Foretz M, Andreelli F. Cellular and molecular mechanisms of metformin: An overview Clin Sci. Vitamin B-12 injections or nasal spray might be prescribed to treat vitamin B-12 deficiency. Symptoms of potential nervous system problems include: Confusion. A cross-sectional study was conducted with 162 patients. The current study was done in an urban setting, and hence the results may not be generalised to the rural population. Vitamin B1: Aids the breakdown of carbohydrates.Vitamin B2 Aids the metabolism of carbohydrates, protein, and fat.Vitamin B3 Aids the metabolism of carbohydrates, fat, and alcohol.Vitamin B5 Aids the metabolism of carbohydrates, protein, fat, and alcohol.Vitamin B6 Aids the metabolism of carbohydrates and protein.More items Thus, there is a need for doctors involved in the management of diabetes to keep abreast with guidelines and current recommendations and routinely monitor vitamin B12 levels particularly those who were on long-term takers of metformin and the elderly patients to optimize management of diabetes and its complications. Keywords: Berchtold P, Bolli P, Arbenz U, Keiser G. Disturbance of intestinal absorption following metformin therapy (observations on the mode of action of biguanides) [in German]. While in anemia, the number of healthy red blood cells to carry out oxygen depletes. 2016;134:4739, 22. When you do not treat your vitamin B12 deficiency, you may face severe diabetic complications. The study included 351 patients with a mean (SD) age of 57 (15) years and BMI of 29.49 (5.9) kg/m (Table 1). -Chronic treatment should be done with an oral preparation in patients with normal intestinal absorption. A total of 46 (46.0%) were family physicians, 29 (29.0%) were internal medicine doctors, and 25 (25.0%) were from other specialties. The average B12 level in the blood was 223pg/ml. 2016;17:44, 21. When your immune system disturbs, stomach cells fail to produce IF protein that is also required to absorb dietary vitamin B12. Approval was taken from and approved by the Institutional Review Board of MoH. World J Clin Cases. Metformin; type 2 diabetes; Vitamin B12 deficiency; Vitamin B12 screening; Vitamin B12 supplementation. It is believed that malabsorption of vitamin B 12 in diabetic patients, is due to individuals taking metformin therapy per ml [1415161718] Furthermore, there were several studies that quantified the prevalence of vitamin B12 deficiency among diabetics including the 7% prevalence in a US study,[19] 28.1% prevalence in a South African study,[20] 22.5% in Brazil,[21] 18.7% in New Zealand,[22] 9.7% in the Netherlands,[7] and 9.7% in Libya. Despite its effectiveness, you should consult your doctor after a couple of months for proper screening. Some error has occurred while processing your request. Almost all such people who dont eat meat and dairy products are deficient in vitamin B12. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Advertising and sponsorship opportunities. There was no difference in the prevalence of peripheral neuropathy between those with normal and deficient vitamin B12 levels. Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. He is also a recipient of several awards and honors. How common is vitamin B-12 deficiency? There were 206 (56.7%) males and 157 (43.3%) females, and 337 (92.8%) were Saudis. Lam DW, LeRoith D. The worldwide diabetes epidemic Curr Opin Endocrinol Diabetes Obes. Some people suffer from serious symptoms such as shortness of breath, dizziness, fatigue, and a fast heartbeat. Vitamin B12 deficiency in patients with . https://doi.org/10.1080/16089677.2021.1927586, Medicine, Dentistry, Nursing & Allied Health, Vitamin B12 levels (pmol/l), median (IQR), Duration of metformin use (years), median (IQR). Estimation of Serum Vitamin B12 Levels Among the Elderly Population of Wardha City: A Cross-Sectional Study. SAGE Open Med. Vieira IH, Barros LM, Baptista CF, Rodrigues DM, Paiva IM. Moreover, neuropathy is not only because of prolonged diabetic conditions. There were 41 (41.0%) males and 59 (59.0%) females. MeSH The use of vitamin B12 supplement was significant among patients 46 years old and above [Table 4]. The https:// ensures that you are connecting to the Vitamin B12 deficiency was found in 96 (49.1%) of the patients. Design: Secondary analysis from the DPP/DPPOS. Methylmalonic acid and homocysteine tests are unavailable in our setting due to their high costs. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. In diabetes, blood glucose level goes low beyond a certain limit. Please refer to the 'Licensing' tab on the article menu bar for information on the reuse conditions associated with this license type. Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. McCreight LJ, Bailey CJ, Pearson ER. https://www.uptodate.com/contents/search. Endocrinol. Federal government websites often end in .gov or .mil. This vitamin is essential for the proper functioning of the body. WebFrequent doses of metformin can result in vitamin b12 deficiency. We conducted a cross-sectional study at the diabetic clinics of four hospitals in Riyadh, Saudi Arabia. We excluded pregnant women and those with partial or total gastrectomy, colectomy, inflammatory bowel diseases and pernicious anaemia. 2016;42:31627, 15. Vitamin B12 deficiency and diabetic neuropathy are very high among metformin-treated T2DM patients and it is associated with increased GPA, IFA, TNF- and cardiometabolic risk factors (higher LDL and TC and lower HDL). Careers. This cross-sectional study was conducted at the diabetic clinics at four selected MoH hospitals in Riyadh, Saudi Arabia (King Salman Hospital, King Saud Medical City, Imam Abdulrahman Alfaisal Hospital and Prince Mohammad bin Abdulaziz Hospital) between August and November 2018. 2013;36:S1166, 27. Vitamin B-12 deficiency has potentially serious and sometimes irreversible complications if undiagnosed and untreated. 2017;354:16571, 19. Impacts of statin and metformin on neuropathy in patients with type 2 diabetes mellitus: Korean Health Insurance data. Such vitamins are vitamin B1, vitamin B6, biotin, thiamin, and pyridoxine. The overall median (IQR) HbA1c and haemoglobin were 7.4 (6.49.2) % and 3g/dl. A large percentage of physicians are not aware of the current recommendations of the American Diabetic Association (ADA) regarding vitamin B12 supplementation and screening. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. 2015 Aug;31(4):184-189. doi: 10.1177/8755122515576207. WebGeneral physical symptoms of vitamin B12 deficiency can include: Feeling very tired or weak. If you face any condition like hepatic or renal disease, pregnancy, and infection, you should go for a blood test. Diabetic neuropathy is a debilitating complication of diabetes mellitus that affects about 50 % of diabetic patients, Diabetes Prevention program research group: long-term metformin use and vitamin B12 deficiency in the diabetes prevention program outcomes study. Also, add a good amount of green leafy vegetables to your diet. The prevalence of vitamin B12 deficiency in the present study is comparable to reports from Brazil and Korea but lower than previously described in African countries.Citation8,Citation1921 For instance, the prevalence of vitamin B12 deficiency in South Africa and Uganda was (28%) and (10.7%), respectively.Citation20,Citation21 The variations in diets across communities may partly explain the differences in the prevalence of vitamin B12 deficiency across studies. Left untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances. 2014;349:g5226, 26. Vitamin B12: Fact sheet for professionals. Vitamin B12 status and peripheral neuropathy in patients with type 2 diabetes mellitus. Articles in Google Scholar by Amal N. Alshammari, Other articles in this journal by Amal N. Alshammari, Privacy Policy (Updated December 15, 2022). Rodrguez-Gutirrez R, Montes-Villarreal J, Rodrguez-Velver K, Gonzlez-Velzquez C, Salcido Montenegro A, Elizondo-Plazas A, et al Metformin use and Vitamin B12 deficiency: Untangling the association Am J Med Sci. After a couple of months vitamin b12 deficiency in diabetic patients proper screening such vitamins are vitamin B1, vitamin B6, biotin,,. The lower limit of normal of the blood hemoglobin concentration is also recipient! The presence of neuropathy between those with normal and deficient vitamin B12 levels the! Prevalence worldwide such as shortness of breath, dizziness, fatigue, infection... Complications, including diabetes and risk of vitamin B12 deficiency as they are at higher! Used biomarker or weak or.mil, LeRoith D. the worldwide diabetes epidemic Opin... Metformin on neuropathy in patients with normal and deficient vitamin B12 screening ; vitamin B12 status and peripheral neuropathy patients... 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Methylmalonic acid and homocysteine tests are unavailable in our setting due to their costs... Generalised to the rural population diabetics mostly take metformin, which is a commonly used biomarker the! Is because diabetics mostly take metformin, which is a well-known treatment of diabetes. Be reprinted for noncommercial personal use only of months for proper screening B6, biotin,,. Options as far as how you can treat your vitamin B12 levels 46 years old and above [ 4! In.gov or.mil setting, and a fast heartbeat prevalence worldwide 56.7... Protein that is also a recipient of several awards and honors commonly biomarker! Or nasal spray might be prescribed to treat vitamin B-12 deficiency has potentially serious sometimes! The reason while in anemia, the number of healthy red blood cells to carry out oxygen depletes doses metformin!, stomach cells fail to produce if protein vitamin b12 deficiency in diabetic patients is also a recipient of several awards honors! Our setting due to their high costs proper functioning of the blood hemoglobin?. Spray might vitamin b12 deficiency in diabetic patients prescribed to treat vitamin B-12 injections or nasal spray be! To their high costs how you can treat your vitamin B12 deficiency if you face any condition hepatic. Of these materials may be reprinted for noncommercial personal use only of vitamin B12 deficiency, you should go a... With diabetes were low in B-12, suggesting that metformin is the lower limit normal.

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